Brain Stem Tumour
Posted: Mon Aug 11, 2003 1:55 pm
This tumour is an Ependyoma. I was told that it probably was present at
birth.
I think Naja covered many of the emotional and physical symptoms. Not the
Nystagmus which was also present. Is it reasonable to stay with this . One
could argue that the Mother was in a Naja state during pregnancy. I have
not seen girl again but am thinking I could advise her to repeat Naja 30c
any time she has the sore throat from grief and tension. Because of
circumstances I do not think I could achieve anything more complex. I
supported the application for Laetrile because of the disappointment the
family would have suffered if it had not been done and the fact they would
have gone to considerable expense and trouble to find it elsewhere. They
had had 4 of the 6 week course and had paid for the remainder. Thank You
Jean
INTRODUCTION Section 2 of 11
Author Information Introduction Clinical Differentials Workup Treatment
Medication Follow-up Miscellaneous Pictures Bibliography
Background: Ependymomas are neoplasms of ependymal cells that occur
throughout the entire neuraxis in association with the lining of the
cerebral ventricles and central canal of the spinal cord.
Pathophysiology: Ependymomas occur most commonly in the intracranial and
intraspinal areas, with lesions rarely occurring in the sacral area. Other
unusual ectopic sites of ependymoma are the mediastinum, ovary, and broad
ligament. In general, the anatomic location determines the
pathophysiological manifestations of the tumor. Supratentorial tumors
present with mass effect, focal neurological signs, and occasional
obstruction of ventricular outflow. The relationship with the ventricular
system is more apparent in tumors of the posterior fossa (mostly of the
fourth ventricle), which usually present with obstructive hydrocephalus with
or without signs of brain stem compression.
Frequency:
* In the US: Ependymomas are infrequent tumors, representing 2-8% of all
brain tumors. However, ependymomas are the third most common brain tumor in
children (8-12%) with up to 30% occurring in children younger than 3 years.
Half of the ependymomas occur in the first 2 decades of life; two-thirds are
located in the posterior fossa (>than 90% are in the fourth ventricle).
Interestingly, despite their overall low frequency, ependymomas are the most
frequent neuroepithelial tumors of the spinal cord.
Mortality/Morbidity: From the biological perspective, ependymomas do not
usually proliferate rapidly, are not invasive, and usually do not
metastasize. The associated morbidity can mainly be accounted for by the
local space-occupying effects of the tumor. In unusual cases, the risk of
sudden death from large intracranial ependymomas results from increased
intracranial pressure secondary to obstructive hydrocephalus.
Race: No race predilection exists.
Sex: No sex predilection exists.
Age: Peak age at presentation ranges from 7 weeks to 16 years with a mean of
3.7 years. A second, lower peak age of presentation occurs in the third
decade of life.
CLINICAL Section 3 of 11
Author Information Introduction Clinical Differentials Workup Treatment
Medication Follow-up Miscellaneous Pictures Bibliography
History: Presenting features are insidious and progressive in nature.
* Nausea and vomiting (80%) is the most common presenting symptom,
secondary to increased intracranial pressure.
* Headache (50%), due to the local effect of pressure or increased
intracranial pressure, is usually worse in the morning.
* Change in behavior (50%) includes lethargy, irritability, diminished
social interaction, and loss of appetite (prevalent in younger children).
* Difficulty with balance (30%) reflects cerebellar involvement or mass
effect.
Physical:
* Papilledema (60%)
* Ataxia (45%)
* Nystagmus with or without gaze palsy (40%)
* Lower cranial nerve palsies (10%)
* Apraxia or hemiparesis (20%)
* Increase in head circumference in children younger than 2 years (10%)
Causes: No particular genetic or molecular marker or familial predisposition
has been identified for this tumor type. In one series, only a few
ependymomas were reported to be hyperdiploid or tetraploid.
[Non-text portions of this message have been removed]
birth.
I think Naja covered many of the emotional and physical symptoms. Not the
Nystagmus which was also present. Is it reasonable to stay with this . One
could argue that the Mother was in a Naja state during pregnancy. I have
not seen girl again but am thinking I could advise her to repeat Naja 30c
any time she has the sore throat from grief and tension. Because of
circumstances I do not think I could achieve anything more complex. I
supported the application for Laetrile because of the disappointment the
family would have suffered if it had not been done and the fact they would
have gone to considerable expense and trouble to find it elsewhere. They
had had 4 of the 6 week course and had paid for the remainder. Thank You
Jean
INTRODUCTION Section 2 of 11
Author Information Introduction Clinical Differentials Workup Treatment
Medication Follow-up Miscellaneous Pictures Bibliography
Background: Ependymomas are neoplasms of ependymal cells that occur
throughout the entire neuraxis in association with the lining of the
cerebral ventricles and central canal of the spinal cord.
Pathophysiology: Ependymomas occur most commonly in the intracranial and
intraspinal areas, with lesions rarely occurring in the sacral area. Other
unusual ectopic sites of ependymoma are the mediastinum, ovary, and broad
ligament. In general, the anatomic location determines the
pathophysiological manifestations of the tumor. Supratentorial tumors
present with mass effect, focal neurological signs, and occasional
obstruction of ventricular outflow. The relationship with the ventricular
system is more apparent in tumors of the posterior fossa (mostly of the
fourth ventricle), which usually present with obstructive hydrocephalus with
or without signs of brain stem compression.
Frequency:
* In the US: Ependymomas are infrequent tumors, representing 2-8% of all
brain tumors. However, ependymomas are the third most common brain tumor in
children (8-12%) with up to 30% occurring in children younger than 3 years.
Half of the ependymomas occur in the first 2 decades of life; two-thirds are
located in the posterior fossa (>than 90% are in the fourth ventricle).
Interestingly, despite their overall low frequency, ependymomas are the most
frequent neuroepithelial tumors of the spinal cord.
Mortality/Morbidity: From the biological perspective, ependymomas do not
usually proliferate rapidly, are not invasive, and usually do not
metastasize. The associated morbidity can mainly be accounted for by the
local space-occupying effects of the tumor. In unusual cases, the risk of
sudden death from large intracranial ependymomas results from increased
intracranial pressure secondary to obstructive hydrocephalus.
Race: No race predilection exists.
Sex: No sex predilection exists.
Age: Peak age at presentation ranges from 7 weeks to 16 years with a mean of
3.7 years. A second, lower peak age of presentation occurs in the third
decade of life.
CLINICAL Section 3 of 11
Author Information Introduction Clinical Differentials Workup Treatment
Medication Follow-up Miscellaneous Pictures Bibliography
History: Presenting features are insidious and progressive in nature.
* Nausea and vomiting (80%) is the most common presenting symptom,
secondary to increased intracranial pressure.
* Headache (50%), due to the local effect of pressure or increased
intracranial pressure, is usually worse in the morning.
* Change in behavior (50%) includes lethargy, irritability, diminished
social interaction, and loss of appetite (prevalent in younger children).
* Difficulty with balance (30%) reflects cerebellar involvement or mass
effect.
Physical:
* Papilledema (60%)
* Ataxia (45%)
* Nystagmus with or without gaze palsy (40%)
* Lower cranial nerve palsies (10%)
* Apraxia or hemiparesis (20%)
* Increase in head circumference in children younger than 2 years (10%)
Causes: No particular genetic or molecular marker or familial predisposition
has been identified for this tumor type. In one series, only a few
ependymomas were reported to be hyperdiploid or tetraploid.
[Non-text portions of this message have been removed]